STATEMENT OF DEAN S. BILLIK, FAAMA, DIRECTOR
CENTRAL TEXAS VETERANS HEALTH CARE SYSTEM
BEFORE THE
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
COMMITTEE ON VETERANS' AFFAIRS
U. S. HOUSE OF REPRESENTATIVES

October 23, 1997

Mr. Chairman and Members of the Committee:

It is an honor and a privilege to appear before you today to testify regarding alleged mismanagement practices while I was Director of the Charleston VA Medical Center.

I welcome the opportunity to address these allegations.

The VA Inspector General completed a thorough investigation of 27 allegations of mismanagement on January 10, 1997. They found no evidence of mismanagement. Of the 27 allegations ranging from gold fixtures in the bathroom of my office to spending $40,000 on a fish tank, five (5) were substantiated and four (4) others were partially substantiated. Of these, a total of six (6) recommendations were made. I will now address each substantiated and partially substantiated allegation and the six (6) recommendations.

Substantiated allegations:

1. Ward 4A was renovated into a Nursing Home Care Unit and never used for this purpose.
   
   At the conclusion of the renovation of Ward 4A, a project to remodel another medical unit had been funded. Rather than reduce capacity for acute care patients we utilized 4A to care for those patients. Had we not been able to use Ward 4A as a "swing space," we would have either had to reduce the number of patients we were taking care of, close clinics, or not complete necessary improvements. None of these were viable options to me. My intent was to use Ward 4A as a Nursing Home as soon as renovations to the other parts of the hospital were complete.
   
   
2. Management received activation funding for the Ward 4A NHCU project even though the NHCU was never opened.
   
   General operating and construction funding was received for this project. This money was utilized for the renovation of Ward 4A and for the operation of the Medical Center. These funds enabled us to reduce employment to a level which the budget could support without incurring a reduction in force.
   
   
3. The Director's suite was renovated without advance approval from VA Central Office on the renovation costs.
   
   The Director's offices, which had not been renovated in many, many years, were renovated. However, before renovation began, the appropriate request was submitted through the Director of the Southern Region to VA Central Office. A verbal approval was received from VA Central Office on January 5, 1996, which is documented.
   
   
4. A consultant was hired and inappropriately paid $800 daily for program analyst services.
   
   VA Central Office had a national contract with APQC to implement Total Quality Improvement (TQI) programs in various VA hospitals across the country. Charleston was one of those selected. When this contract expired, it was felt that we were not ready or able to implement our TQI program without continued support. Supply Service was requested to extend the contract for another year. The rate was not set by me, nor did I select the original contractor. The original contract, which seemed to be reasonable at the time, was merely extended.
   
   
5. Scarce funds were spent on a maintenance contract for the fish tank while employees were facing layoffs and anesthesia machines were not covered by service agreements.
   
   
   • The maintenance contract for the fish tank was $7,800 per year, which included stocking, feeding the fish, cleaning, and replacing dead fish. A projected budget shortfall in FY 1996 did not materialize. The perception may have been that money was being spent frivolously while employees were facing layoffs. However, construction money for renovating the lobby or installing the fish tank could not have been spent on employee salaries, no matter how desirable this would have been.
     
   • It is also true that the anesthesia machines no longer have a maintenance contract because it was determined that the maintenance of these machines could be accomplished more effectively by the Medical Center's biomedical staff and thereby save money.

Partially substantiated allegations:

1. A well-known local artist's painting was inappropriately discarded as a part of the renovation of the Director's suite.
   
   
   • I don't know anything about this painting.
   
   
   
2. A $40,000 fish tank was unnecessarily purchased for the Medical Center lobby.
   
   
   • The cost of the fish tank was actually $26,119. An interior designer who developed a hospital master plan included the tank as a focal point in the lobby project. She considered paintings or a sculpture, but she felt a fish tank would be nice and appropriate since Charleston is a seaport. While it is not a necessity, it was part of an overall Project. It is pleasing to all who visit, the old and the young, and we have received nothing but compliments from patients and family members on the fish tank.
   
   
   
3. Management authorized nonessential landscaping services and redirected the old landscaping items to an employee's residence.
   
   
   • This is partially substantiated because at one time an employee had taken some old plants home with him. Staff were reminded that all plants were Government property and were to be disposed of and not given to employees. A memorandum was issued to employees; the IG was satisfied that the problem had been corrected; and no recommendations were made. The IG also stated in their report that "with the amount of exterior construction projects either recently completed or still underway, we could see how some employees may have the impression that constant changes are being made to the landscaping. We did not see any evidence of wasteful spending in this area." The Medical Center's landscaping is attractive, but not lavish considering how little greenery there is on the grounds.
   
   
   
4. Management violated its own policies by requiring respiratory therapists to work without backup in the intensive care unit during the evening hours.
   
   
   • This allegation was partially substantiated. Respiratory therapists were required to work alone in the intensive care unit during the evening hours because of a declining inpatient workload at the Medical Center. However, in the event that another respiratory therapist was needed, assistance could be obtained from the respiratory therapist working in the sleep laboratory. This was not consistent with existing policy, and the policy has since been changed. The new policy is consistent with other VA medical centers.
   
   
   

Recommendations:

1. The Medical Center Director ensure that all equipment purchased for the NHCU in FY 1995 be accounted for so that it can be reconstituted in the NHCU once it is opened.
   
   
   • As of December 2,1996, the Acquisition and Materiel Management Service of the Medical Center had accounted for all equipment items purchased for the NHCU. These items will be transferred to the NHCU once it becomes operational.
   
   
   
2. The Medical Center Director should carefully evaluate the options regarding the fish tank and determine whether continued use of the tank is in the best interests of the Medical Center.
   
   
   • The current Medical Center Director has determined that it would cost approximately $27,394 to remove the fish tank from its present location in the front lobby. Due to the nature of the initial construction, removing the fish tank would also destroy the interior design and uniformity of the lobby. Additionally, many positive comments from patients, family members, and the general public have been received regarding the fish tank. They support keeping the fish tank as part of the lobby.
   
   
3. We recommend the Director, Veterans Integrated Service Network 7, take action to ensure that the former Director and current management at the VA Medical Center are aware of the appropriate procedures to follow when requesting advisory and assistance services.
   
   
   • Both the current Director of the Charleston VAMC and I are aware of the appropriate procedures to follow when requesting consultative services. It is my understanding that the contract for the consultant was terminated effective December 31, 1996.
   
   
   

4. We recommend the Medical Center Director take action to:

   
   

   • Discontinue using the fee basis authority to pay for the management consultant's services, and re-evaluate whether advisory and assistance work continues to be needed at the Medical Center.
     
   • Develop the required "concept approval" documents and submit an official request for the consultant's services to the VISN if it is determined that these services are still needed. It is my understanding that the consultant in question was terminated effective December 31, 1996. If a consultant's services are deemed necessary in the future, the procedures outlined in Circular 00-92-15 will be followed.
   
   

   
   

5. We recommend the Medical Center Director consider the cost of the annual maintenance contract for the fish tank in deliberations on the options related to the future of the fish tank.
   

   
   

   • The current maintenance contract for the fish tank runs through September 30, 2000. I am sure other alternatives for maintaining the tank will be explored when this contract expires.
   
   
   
6. The Medical Center Director should take appropriate action to ensure that the employees are appropriately advised on their employment rights as they pertain to current and future plans for retaining private cleaning services at the Medical Center.
   
   
   • It is my understanding that this is the current practice, and it will continue to be communicated at staff meetings.
   
   
   

Allegations that excessive amounts of money were spent for remodeling the Director's office and allegations related to the remodeling of the Director's office were thoroughly investigated and not substantiated.

Allegations that friends were non-competitively promoted were thoroughly investigated by the IG and not substantiated.

There has been concern expressed about the hiring of Ms. Shannon Falcone. Ms. Falcone was an Administrative Resident at the VA Medical Center in San Antonio, Texas. As the Associate Director of that center from 1985 through 1992, I had the opportunity to work with and know more than 18 such residents.

Due to turnover of staff in my office in Charleston, I recruited Mrs. Mary Bowrin to fill a vacant administrative assistant position. Included in Mrs. Bowrin's experience was the Director of Personnel for the Secretary of Housing and Urban Development in Washington, D.C. In that position she was a GM-14.

The next position which became vacant was that of my staff assistant. I first asked an experienced person, Mr. Tom Balderach of the Big Spring VA Medical Center, to consider transferring; however, he declined. I then asked Ms. Falcone to consider the position, which she eventually did. Her appointment was consistent with many other residents that were appointed during my tenure in San Antonio.

Ms. Falcone's progress from a GS-11 to GS-12 to GS-13 was consistent with past practice for employees in such positions. The journeyman grade for Health Systems Specialists at hospitals like Charleston was GM-13. Her performance was fully successful, and she should have been promoted.

I learned of my future reassignment from Charleston in early 1996 (February or March). I discussed this with Ms. Falcone. We concluded that we cared for each other to the point that we did not wish to be separated. She decided at that time to leave the VA as soon as was reasonable. I left Charleston in September 1996, and Ms. Falcone left Government service at the end of October 1996. We were married in December 1996.

In conclusion, there is NO evidence of mismanagement. This matter has been thoroughly investigated by the VA Inspector General and is well documented in their final report dated January 10, 1997. Everything I did at Charleston VA Medical Center was always for the benefit of our veterans and for the benefit of the Medical Center. I never have, and never will, do anything to hurt a veteran. I have done nothing illegal nor inappropriate.

I appreciate the opportunity you have given me to explain the facts in this matter and to address you today. Thank you.

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